“In many poor countries, older surgeons resist being questioned, and operations are more often emergencies, which leaves less time to review checklists.
Outside influences can be powerful, the report noted. It singled out the charity Mercy Ships as instrumental in introducing the checklist to Africa. Mercy Ships has a hospital ship that docks for months in various port cities in Africa, performing thousands of surgeries.
At each port of call, it also trains dozens of local medical practitioners.
When the Africa Mercy was docked in Cotonou, Benin, from 2016 to 2017, for example, it sent teams to 36 hospitals to lead workshops in using a surgical checklist.
Before the training, only about 30 percent of surgeries performed incorporated checklists. Afterward, nearly 90 percent did — and compliance was still at 86 percent during follow-up visits a year later.”